Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study

Background. The cephalic antebrachial vein is often used forvenous access. However, superficial radial arteries of the forearmare known and unintentional arterial puncture can result fromattempts to cannulate the lateral veins of the arm. Methods. Accidental puncture of a superficial radial arteryduring peripheral venous cannulation prompted us to study theanatomy of 26 specimens and to assess the relationship betweenthe radial artery and the cephalic vein in the forearm. Results. In two cases, we found accessory branches of the radialartery close to the cephalic forearm vein. Venous cannulationat the lateral wrist carries a small risk of arterial punctureif arterial anomalies are present. Conclusions. If venous cannulation is attempted at the radialside of the wrist, palpation for pulsation should reduce thedanger of arterial puncture. Br J Anaesth 2004: 92: 740–2